This was a retrospective observatory analysis study.
The objective of this study was to compare the differences in clinical and radiologic outcomes among patients who underwent anterior cervical corpectomy and fusion
(ACCF) using titanium mesh cage
(TMC) with end-caps and patients who underwent ACCF using TMC without end-cap
Summary of Background Data:
TMC has been widely used as an effective treatment option for ACCF. However, the subsidence of TMC has been observed frequently in the early postoperative period in some cases, resulting in related clinical complications.
Materials and Methods:
Patients who underwent single-level ACCF using TMC from September 2008 to June 2014 at our institute were retrospectively reviewed. Patients treated with TMC with end-cap
were classified as an end-cap
group, while patients treated with TMC without end-cap
classified as a control group. The round press-fit–type end-caps with 2.5-degree angulation were used at both ends of the cage for the end-cap
group. Patients were followed postoperatively for a minimum of 36 months with radiologic evaluation.
The subsidence was lower in the end-cap
group (4.3±3.6 vs. 4.8±3.0, P
<0.01), with lower rates of severe subsidence (≥3 mm) than the control group (34.2% vs. 52.1%, P
<0.01). Visual analogue scale (VAS) scores for neck pain and Neck Disability Index (NDI) was reported significantly less in the study group, which showed a positive correlation with lesser severe subsidence. Also, the characteristics of subsidence differed between the 2 groups. In the end-cap
group, slippage type subsidence occurred, resulting in better sagittal alignment than that in the control group.
For patients undergoing single-level ACCF, using TMC with end-cap
provided better clinical results and similar fusion rate, compared with using TMC without end-cap
. The end-cap
decreased the severity of postoperative subsidence
and related neck pain. Also, sagittal alignment was well preserved, suggesting it may contribute to cervical lordosis